Oral appliances for sleep apnea: real costs, CPAP comparison, and how to get one

By SleepApneaSelect. Prices and rules checked October 7, 2026.

An oral appliance for sleep apnea is a mouthpiece you wear at night. The usual type holds your lower jaw forward to help keep your throat open. People also call it a sleep apnea mouth guard, a mouthpiece, or a dental device.

It is a real treatment. Sleep medicine guidelines (opens in a new tab) back a custom, adjustable appliance made by a trained dentist for adults with obstructive sleep apnea (OSA). It can reduce pauses and shallow breathing during sleep. CPAP generally reduces them more.

It is not cheap. We found three providers that publish a price for a custom appliance: $2,400, $2,995, and $3,490. Each price covers different things. Medical insurance may cover part when you meet the plan's rules.

This page shows what those prices include, how an appliance compares with CPAP, what Medicare and insurance cover, and what to ask before you pay.

Already diagnosed and ready to talk to a dentist?

Talk with your sleep clinician before you change a treatment you already use.

Not diagnosed yet? Snoring alone can't tell you if you have sleep apnea. A medical provider should assess you and choose the right sleep test. Compare home sleep tests.

Provider links on this page are unpaid. Advertising disclosure.

Jump to: Costs · Quote worksheet · Appliance vs. CPAP · Who it fits · Best mouthpiece · Insurance and Medicare · How to get one · Side effects

Which mouth guards actually treat sleep apnea?

Only some do. "Mouth guard" covers four very different products. Know which one you are looking at before you compare prices.

Sources: AASM and AADSM guideline (opens in a new tab); Sleep Doctor's ApneaRx listing (opens in a new tab) (opens in a new tab) and myTAP listing (opens in a new tab) (opens in a new tab), each $199 with a prescription required. The custom prices are sourced in the next table.

Why the $199 kind is not the same thing. The 2015 guideline pooled older trials. Custom appliances cut breathing events by about 14 per hour. Ready-made ones cut about 6. The ready-made estimate came from only two small trials with 42 people and was uncertain. These were separate pooled results, not a test of today's $199 models.

Newer evidence is more encouraging for some devices. A 2022 trial (opens in a new tab) found similar short-term results with myTAP and custom TAP, fitted and followed by clinicians. It enrolled 58 people; 40 finished. That does not prove every ready-made device works as well, or that fitting one yourself gives the same result. AADSM guidance (opens in a new tab), reviewed without changes in 2025, supports temporary appliances in selected, dentist-supervised cases while favoring custom appliances for long-term care. Medicare does not cover prefabricated appliances (opens in a new tab).

How to check what a mouthpiece is cleared for

Look for the words "Indications for Use" on the product's FDA paperwork. "FDA cleared" can mean cleared for snoring only.

Here is a real example. The FDA clearance for the VitalSleep mouthpiece (opens in a new tab) (opens in a new tab) lists over-the-counter use to reduce snoring in adults. It does not list sleep apnea. The ProSomnus CA Sleep and Snore Device (opens in a new tab) (opens in a new tab) is prescription-only and is cleared for nighttime snoring and mild to moderate obstructive sleep apnea in adults.

Snoring often comes with sleep apnea. Only a medical provider can rule sleep apnea out. If a store guard makes you quieter, that does not tell you your breathing is okay.

How much does an oral appliance for sleep apnea cost?

We found three providers that publish a price for a custom appliance: $2,400, $2,995, and $3,490. Those prices are not for the same package. One includes three months of adjustment visits. One lists a $995 charge that insurance won't pay back. Follow-up testing costs need checking. Daybreak says its home sleep test includes nights for checking treatment; confirm how that applies to your package, especially if you bring an outside sleep study.

Published prices checked October 7, 2026. Listed in alphabetical order. This is not a ranking, and three prices are not an average.

Sources: BlueSleep pricing (opens in a new tab) (opens in a new tab) and testing and treatment process (opens in a new tab) (opens in a new tab); Daybreak pricing (opens in a new tab) (opens in a new tab), insurance (opens in a new tab) (opens in a new tab), FAQ (opens in a new tab) (opens in a new tab) and government-plan disclosure (opens in a new tab) (opens in a new tab); Eden Lakes Dental sleep devices (opens in a new tab) (opens in a new tab). These are the companies' own statements. We did not buy, test, or get a private quote from any of them.

Daybreak's price breakdown. Its insurance page lists devices starting at $2,495. That plus the $995 Treatment Essentials charge equals its advertised $3,490 full treatment cost: $2,495 + $995 = $3,490. Do not add another $995 to that advertised full price. Ask for the itemized amount you would pay.

A warranty is not a refund promise. Daybreak's 3-year manufacturing warranty covers defects in materials or workmanship and excludes ordinary wear, misuse and other listed causes. Its separate Patient Care Guarantee (opens in a new tab) (opens in a new tab) has a 90-day treatment window and strict conditions. It may refund the initial device cost if neither outcome target is met within 90 days of receiving the device: a reduction of at least 50% in AHI or RDI, or a score below 5. All other conditions must also be met. That refund threshold is a company policy. Your clinician still needs to judge whether treatment controls your sleep apnea. Medical and dental service fees are nonrefundable. Required follow-up tests, treatment and care instructions, eligibility, and returning the device all matter. Check-ins and requests must be completed within two weeks of receiving them. The return policy (opens in a new tab) (opens in a new tab) also allows a refund for clinical disqualification, but does not offer a general change-of-mind return for the custom treatment.

Your local dentist's price may be higher or lower. These three offers do not establish a nationwide price range. A written quote for you beats any range.

The price on the page is not the whole bill

Here is how fast it adds up if you need a new evaluation and test, using BlueSleep's own published fees.

$115 + $115 + $215 + $19.50 = $464.50; $464.50 + $2,400 = $2,864.50. This is our math from BlueSleep's price list (opens in a new tab) and shipping charge (opens in a new tab). The $464.50 is the same selected-service subtotal shown in our testing cost example. It is not a quote from BlueSleep. If you already have an accepted sleep study, you may not need the same testing services. Confirm all required care and fees for your case.

Two more things to know:

• A deposit is not a discount. Eden Lakes says its $25 coverage-check fee goes toward treatment if you proceed. If the office applies it to the posted $2,995 device charge, $2,995 − $25 = $2,970 remains toward that charge. The device price is still $2,995. Confirm any other treatment costs.
• A lower device price is not always a lower total. The gap between BlueSleep and Eden Lakes is $2,995 − $2,400 = $595. But the two prices cover different care, so you can't tell which costs less overall until both offices fill in the blanks.

What a full quote should spell out

Ask the office to mark each line as included, extra, or not known yet.

Have a quote in hand? Type it in below. You can also copy the questions to take with you.

Questions about oral appliance treatment for obstructive sleep apnea

1. Please send me a written estimate for the full treatment.
2. Which exact device do you recommend for me, and why?
3. Will the exam, the scan or mold of my teeth, and the bite record be done in person?
4. What does the price include: exam, device, fitting, adjustment visits, check-ups? For how long? What costs extra?
5. Who orders and reads the follow-up sleep test with the device in? Is it included?
6. What happens if I can't wear it, or the test shows it isn't working well enough? Is any money refunded?
7. What are the repair, remake, and warranty terms? What if I get dental work later?
8. How will you watch for changes in my bite?
9. Do you bill my medical insurance? Are you in network? Are you enrolled with Medicare?
10. What is my estimated share? Does it already subtract any deposit? What would I owe if the claim is denied?

Questions about coverage for a custom oral appliance for obstructive sleep apnea

1. Is a custom oral appliance for obstructive sleep apnea covered under my medical plan? Which policy and billing code apply? (Dentists often bill code E0486.)
2. Do my sleep test and diagnosis meet your rules? Do I have to try CPAP first?
3. Is this provider in network for this service? Does this exact device qualify?
4. Is prior authorization needed? Who sends it in?
5. What is your allowed amount, and what is my share after my deductible and coinsurance?
6. Are follow-up visits and a follow-up sleep test covered, or billed separately?
7. When can the device be replaced?
8. Can I get this answer in writing, or a reference number for this call?

A worked example. Say a quote reads $2,995 and you already paid a $25 fee toward it. Type 2995 as the main amount and 25 as already paid. Leave the rest as "Not sure yet." The worksheet shows: known so far $2,995.00, left to pay $2,970.00, and a list of nine things still to confirm. It will not call that a total, because it isn't one yet.

Is a high quote a rip-off?

Price alone can't tell you. For example, a $4,000 quote that includes a year of visits and the follow-up sleep test may cost less than a $2,400 quote that doesn't, once extra fees are added. These are hypothetical packages. Compare the same care over the same length of time. If an office can't explain its quote in writing, get a second one.

Oral appliance vs. CPAP: which works better?

CPAP generally controls breathing better. An oral appliance is easier for many people to wear. Both of those matter, because a treatment only works while you use it during sleep.

These are averages from different studies, not a forecast for you. The breathing and oxygen figures come from pooled trials in the 2015 guideline; the hours of use come from the 2025 CHOICE trial. The reduction of about 14 events is from the custom-appliance subgroup. The CPAP comparisons pool several appliance designs. "Breathing events" includes pauses and reductions in breathing.

Where the numbers come from:

• The pooled trials. The 2015 guideline from two U.S. professional groups, one for sleep doctors and one for sleep dentists (opens in a new tab) combined 34 trials with 1,301 people in its overall breathing-event analysis. Appliances cut breathing events by 13.6 per hour on average; the custom-appliance subgroup averaged 13.9. In the 15 trials that compared appliances with CPAP, CPAP cut 6.2 more per hour. The gap in people who quit over side effects (14 versus 25, across 8 trials) was not statistically conclusive.
• A newer trial. In the CHOICE trial, published in 2025 (opens in a new tab), 73 people entered the crossover phase and tried each treatment for a month. Sensors tracked real use. Across the study nights, average use was 6.0 hours with the appliance and 5.3 hours with CPAP, a difference of 0.7 hours. CPAP still reduced the breathing-event index by 10.4 more events per hour.

The 2015 guideline found no consistent way to predict success from factors such as age, weight and neck size. Your clinicians may use further assessments, but a follow-up sleep test is still needed to check your response.

What the guidelines say to try first

They frame the first choice differently.

• The 2015 guideline says CPAP should generally come first. It says an appliance is better than no treatment for adults who can't use CPAP or would rather not.
• The 2025 VA and Department of Defense guideline (opens in a new tab) (opens in a new tab) goes further for milder cases. For adults with mild to moderate sleep apnea (under 30 events per hour), Recommendation 18 suggests either a jaw-advancing appliance or positive airway pressure (PAP, which includes CPAP) as a first choice.

So if your sleep apnea is mild or moderate, it is fair to ask your clinician about starting with an appliance.

If CPAP is hard, you don't have to quit it

Your sleep team may help with a different mask, a humidifier, or changes to pressure and comfort settings. The AASM patient guide (opens in a new tab) explains these options. Ask before you give up. Some people keep CPAP at home and use an appliance for travel. Your clinician can tell you if that plan works for you and check that each treatment controls your breathing.

See when to go back to a clinician. Staying with CPAP and need a machine? Compare CPAP buying options.

Who is a good fit for an oral appliance?

The best fit is an adult with obstructive sleep apnea who has healthy teeth and gums and wants something other than CPAP. Your sleep test and a dental exam decide it. No quiz can.

First, the number on your sleep report. It counts breathing events per hour. The VA/DoD guideline (opens in a new tab) calls 5 to under 15 mild, 15 to under 30 moderate, and 30 or more severe.

Tell the dentist about these before you order

The appliance grips your teeth and holds your jaw forward. A dentist needs to look first if you have:

• Loose teeth or gum disease
• Missing teeth, dentures, bridges, crowns, or implants
• Jaw pain, clicking, or locking. These need assessment before choosing or adjusting a device.
• A night guard, a retainer, or clear aligners
• Dental work planned soon. Tell the dentist before the appliance is made, because the work can change its fit.

We haven't screened you. A clinician decides what fits.

What is the best sleep apnea mouthpiece?

There is no single best one. The evidence points to a type, not a brand: custom-made, adjustable, and fitted by a trained dentist. The guideline recommends a type, not a best brand. The best device for you is the one that fits your teeth and comes with real follow-up.

When a dentist suggests a model, compare these:

1. Is it cleared to treat sleep apnea? Not just snoring.
2. Is it made from your teeth? A scan or mold, not a stock tray.
3. Can it be adjusted in small steps? The dentist can adjust the jaw position over time.
4. Does it suit your mouth? Crowns, implants, grinding, and allergies to metal or acrylic all change the pick.
5. What happens if it breaks or stops fitting? Get the repair and remake terms.
6. On Medicare? Ask if this exact device is on the PDAC product list for code E0486. That is coding verification, not a promise of coverage.

Names you may hear from a dentist include Herbst, TAP, SomnoDent, and ProSomnus. Herbst describes a design; the others are product families or brands. We are not ranking them. We have not tested these devices or found evidence that one is best for everyone.

Can I try a cheap mouthpiece first?

A dentist may use a prescription temporary appliance to help assess whether a custom one is worth pursuing, or while dental work is underway. That is different from testing yourself with a store snoring guard. Comfort or quieter snoring alone cannot show that your sleep apnea is controlled. Ask what the trial can tell you, what it costs, and how breathing will be checked. This is the selected, supervised use described in AADSM's temporary-appliance guidance (opens in a new tab).

Does insurance cover an oral appliance for sleep apnea?

It can. Treatment for diagnosed obstructive sleep apnea is generally billed through medical insurance. Coverage depends on your plan's rules, your sleep test, the prescription, and the device. Check the policy before paying.

What to know about private plans:

• A claim sent is not a claim paid. A dentist who "bills your insurance" has not promised your plan will pay.
• Check the dentist's medical-plan network status. Being in your dental network does not establish that. Ask before your first visit.
• Plans set their own rules. For example, Aetna's oral-appliance policy (opens in a new tab) (opens in a new tab) includes the first 90 days of follow-up care in the device payment. It considers replacement medically necessary after 5 years, or sooner for a change in the member's condition. Your benefits and the other coverage requirements still apply.
• Snoring alone does not meet the OSA coverage rules. Medicare and the Aetna policy above exclude appliances used only for snoring.

Do I have to fail CPAP first?

Not always. Medicare (opens in a new tab) adds a PAP-intolerance or contraindication requirement when your AHI or RDI is over 30. Private plans differ. UnitedHealthcare's Commercial and Individual Exchange policy (opens in a new tab) (opens in a new tab), effective October 1, 2026, requires a clinician to document that PAP was ineffective, intolerable, or refused. Your plan's other coverage requirements still apply; refusal alone does not guarantee payment. Ask for the rule in writing. Don't guess.

Does Medicare cover oral appliances for sleep apnea?

Yes, if you meet the coverage rules. Under Original Medicare, a qualifying custom jaw-advancing appliance can be covered as durable medical equipment (DME) under Part B. The sleep-test thresholds below are only part of the requirements.

Sources: Medicare coverage rule L33611 (opens in a new tab) (opens in a new tab) and its policy article A52512 (opens in a new tab) (opens in a new tab). Both current revisions show an effective date of August 8, 2021.

The test itself must be Medicare-covered and meet the policy's scoring, recording and provider requirements. A headline AHI from a report is not enough to establish coverage. Ask the dentist and ordering clinician to check the actual report and documentation.

What you pay with Original Medicare. After you meet your Part B deductible, the standard share is 20% of the Medicare-approved amount, if the dentist accepts assignment. That is Medicare's standard rule for medical equipment (opens in a new tab) (opens in a new tab). Other coverage may pay some of that share. It is 20% of what Medicare approves, not 20% of the dentist's cash price. Ask the dentist for the Medicare-approved amount that applies to your claim and your estimated share in writing. If you have Medicare Advantage (opens in a new tab) (opens in a new tab), check your plan's network and cost-sharing rules.

In the prices we checked, BlueSleep and Eden Lakes Dental say they work with Medicare. Daybreak says it can't bill government plans.

Questions to ask your insurance plan

1. Is a custom oral appliance for obstructive sleep apnea covered under my medical plan? Which policy and billing code apply? (Dentists often bill code E0486.)
2. Do my sleep test and diagnosis meet your rules? Do I have to try CPAP first?
3. Is this provider in network for this service? Does this exact device qualify?
4. Is prior authorization needed? Who sends it in?
5. What is your allowed amount, and what is my share after my deductible and coinsurance?
6. Are follow-up visits and a follow-up sleep test covered, or billed separately?
7. When can the device be replaced?
8. Can I get this answer in writing, or a reference number for this call?

How to get an oral appliance, step by step

Start with a diagnosis from a medical provider and a qualified dentist to make and fit the device. A medical order may also be needed for insurance or under applicable prescribing rules. Then a follow-up sleep test checks how well it works.

1. Get assessed and tested. A medical provider chooses the right sleep test to check for sleep apnea and its severity. Compare home sleep tests.
2. Get your report and any required order. Ask for a copy of your sleep study. Confirm who prescribes the appliance and what medical order your insurer requires. How to request your records.
3. Check your coverage. Use the insurance questions above before you book.
4. See a trained dentist in person. The dentist checks your teeth, gums, jaw muscles, and jaw joints.
5. Get scanned. The dentist takes a scan or mold of your teeth and records your bite.
6. Get fitted. The device comes back from the lab. At Eden Lakes Dental, that takes about three weeks. The dentist checks the fit and shows you how to use and clean it.
7. Adjust it slowly. The dentist moves your jaw forward in small steps. Expect a visit within 30 days.
8. Retest. Go back to your medical provider for a sleep test with the device in. Feeling better is not proof.
9. Keep your check-ups. Every 6 months in the first year, then at least once a year. Go sooner if there is a problem.

Steps 4, 5, 7, 8, and 9 come from the dental sleep medicine standards updated in 2025 (opens in a new tab) and the AADSM's patient guide (opens in a new tab).

What about mail-in impression kits?

Those same 2025 standards say three steps should happen in person: the exam, the impressions, and the bite record. Video visits can be used for teaching and some follow-up.

Two of the providers in our price table list or use home impression kits. If you are looking at one, ask how you get the in-person exam, impressions and bite record, and who checks your teeth and bite over time.

How to check a dentist

Look for a licensed dentist with extra training in dental sleep medicine. The 2025 AADSM standards (opens in a new tab) use "qualified dentist" for dentists with one of these credentials:

• Diplomate of the American Board of Dental Sleep Medicine
• AADSM Qualified Dentist
• ABDSM International Certificant

The AADSM directory (opens in a new tab) lists dentists who hold its credentials. Being listed doesn't tell you the price or whether your plan is accepted. Ask.

Questions to ask a sleep dentist

1. Please send me a written estimate for the full treatment.
2. Which exact device do you recommend for me, and why?
3. Will the exam, the scan or mold of my teeth, and the bite record be done in person?
4. What does the price include: exam, device, fitting, adjustment visits, check-ups? For how long? What costs extra?
5. Who orders and reads the follow-up sleep test with the device in? Is it included?
6. What happens if I can't wear it, or the test shows it isn't working well enough? Is any money refunded?
7. What are the repair, remake, and warranty terms? What if I get dental work later?
8. How will you watch for changes in my bite?
9. Do you bill my medical insurance? Are you in network? Are you enrolled with Medicare?
10. What is my estimated share? Does it already subtract any deposit? What would I owe if the claim is denied?

You can copy both question lists from the quote worksheet.

Side effects and risks

Most side effects are in your mouth and jaw. One deserves real thought before you start: your bite can slowly change. The 2025 AADSM standards (opens in a new tab) call for dentists to check for these effects and manage them over time.

Common, and often early:

• Sore teeth or gums
• Sore jaw muscles
• Extra saliva, or a dry mouth
• A bite that feels off when you wake up

The one to weigh: bite change. Wearing the device night after night pushes on your teeth. In one two-year study (opens in a new tab) in the guideline, people's overbite shrank by about 1.2 mm and their overjet (how far the top teeth sit in front of the bottom teeth) shrank by about 1.5 mm, on average. That is small, but it can be lasting. If you paid for braces and love your bite, bring this up first.

Jaw joint. An appliance can make jaw joint pain worse.

Under-treatment. A device can quiet your snoring and still leave your breathing only partly fixed. This is the reason for the follow-up sleep test.

Call your dentist if you have pain that doesn't fade, a bite that stays changed during the day, a loose tooth, or a device that cracks or stops fitting. Call your medical provider if you are still sleepy or your symptoms come back.

More questions

Will an oral appliance stop my snoring?

It can reduce snoring, but may not stop it. The guideline rates oral appliances as effective for reducing snoring. Just remember that quieter is not the same as treated.

How long does an oral appliance last?

It varies. Medicare's 5-year reasonable useful lifetime is a replacement rule, not a promise about how long your device will last. Earlier replacement may qualify for loss, theft, or irreparable damage from an accident or natural disaster; everyday wear does not qualify. Daybreak's 3-year manufacturing warranty covers defects with exclusions, and BlueSleep says its warranty depends on the device. Ask for the warranty and replacement terms in writing.

Does an oral appliance cure sleep apnea?

No. It helps control sleep apnea while you wear it during sleep. Follow your treatment plan and wear it for the whole time you sleep. If you lose a lot of weight or your health changes, ask your clinician to recheck you before you stop.

Can I wear it with a night guard, a retainer, or aligners?

It depends on the devices and your dental treatment plan. Bring every device you use to your dental visit and ask for one plan. Don't trim or stack them yourself.

Does dental insurance ever pay?

Start with your medical plan. An appliance for diagnosed sleep apnea is generally billed there, even though a dentist makes it. Ask both plans about your actual benefits. A dental benefit for a grinding guard does not establish coverage for a sleep apnea appliance.

Your next step

How we checked this page

We read the sources ourselves on October 7, 2026.

• Prices come from each provider's own public page. We did not buy anything, book a visit, or ask for a private quote. Prices change. Confirm before you pay.
• Medical facts come from clinical guidelines, original studies, FDA records and the dental sleep medicine standards linked above. The pooled treatment figures come from the 2015 joint guideline. We also checked the 2025 VA/DoD guideline, current AADSM standards, the 2025 CHOICE trial and newer evidence on supervised temporary appliances.
• Medicare rules come from Medicare's own coverage documents and Medicare.gov.
• What we did not do: test any device, verify anyone's insurance, or have a clinician review this page.

When we add up prices, we show the math and call it our calculation. When a provider doesn't state something, we say "not stated" instead of guessing.

Read how we compare and our editorial standards. See a price or rule that has changed? Send us the source.

This page is for learning and comparing. It is not medical advice, a diagnosis, or a price quote.

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